An Economy Doing Half Its Job: Findings of Harvard Business School's 2013–14 Survey on U.S. Competitiveness

Michael E. Porter; Jan   Rivkin

Report | 2014

An Economy Doing Half Its Job: Findings of Harvard Business School's 2013–14 Survey on U.S. Competitiveness

Abstract

In 2013–14, Harvard Business School (HBS) conducted its third alumni survey on U.S. competitiveness. Our report on the findings focuses on a troubling divergence in the American economy: large and midsize firms have rallied strongly from the Great Recession, and highly skilled individuals are prospering. But middle and working-class citizens are struggling, as are small businesses. We argue that such a divergence is unsustainable, explore its root causes, and examine actions that might mitigate it. We ask in particular, how can we create a U.S. economy in which firms both thrive in global competition and lift the living standards of the average American?

Keywords: Competition; Economy; Financial Crisis; United States;

Language: English

Format: Print

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Citation:

Porter, Michael E., and Jan Rivkin. "An Economy Doing Half Its Job: Findings of Harvard Business School's 2013–14 Survey on U.S. Competitiveness." Report, Harvard Business School, September 2014. (With contributions from Joseph B. Fuller, Allen S. Grossman, Rosabeth Moss Kanter, and Kevin W. Sharer.)

Article | Health Affairs

Navy Medicine Introduces Value-Based Health Care

Alee Hernandez, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III and Michael E. Porter

In 2016 the newly appointed surgeon general of the Navy launched a value-based health care pilot project at Naval Hospital Jacksonville to explore whether multidisciplinary care teams (known as integrated practice units, or IPUs) and measurement of outcomes could improve the readiness of active duty personnel and lower the cost of delivering care to them, their dependents, and local retirees. This article describes the formation of the project’s leadership structure; the selection of four conditions to be treated (low back pain, osteoarthritis, diabetes, and high-risk pregnancy); the creation of the care team for each condition; outcomes and costs measured; and the near-term changes in outcomes during the twelve-month pilot period. Patient outcomes improved for three of the four conditions. We describe factors that contributed to the project’s success. After the pilot concluded, the Navy combined the back pain and osteoarthritis IPUs into a single musculoskeletal clinical unit and established a similar IPU at another naval hospital and its clinics. The diabetes IPU was continued, but the high-risk pregnancy IPU was not. We offer several observations on the elements that were key to the success of the project, explore challenges and opportunities, and suggest that the pilot described here could be taken to greater scale in the Military Health System and elsewhere.

Keywords: military health system; Health Care and Treatment; Cost Management; Projects;

Citation:

Hernandez, Alee, Robert S. Kaplan, Mary L. Witkowski, C. Forrest Faison III, and Michael E. Porter. "Navy Medicine Introduces Value-Based Health Care." Health Affairs 38, no. 8 (August 2019): 1393–1400. View Details

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An Economy Doing Half Its Job: Findings of Harvard Business School's 2013–14 Survey on U.S. Competitiveness

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